Simple, Cheap Health Remedies Cut Child Mortality In Ethiopia

Almaz Acha sits with her baby Alentse at her home in the rural community of Sadoye, in southern Ethiopia. Families in rural communities, like this one, have benefited from Ethiopia's health extension program.

Community health worker Foos Muhumed Gudaal treats kids for malaria, respiratory infections and diarrhea at her post in the village of Walgo Yar, Ethiopia.

Jason BeaubienNPR

Poor countries are starting to realize something that richer ones sometimes forget: Basic, inexpensive measures can have dramatic impacts on the health of a country. And they can save thousands of lives.

Take, for instance, the situation in Ethiopia.

The country used to have one of the highest rates of child mortality in the world.

"If you were a kid born in 1990 [in Ethiopia], you had a 1 in 5 chance of not surviving to your fifth birthday," says Peter Salama, who directs UNICEF's efforts in Ethiopia.

Since then, the country has improved that survival rate by about 60 percent. "So [Ethiopia has made] a tremendous achievement in the space of two decades," Salama says.

This progress isn't a result of expensive international aid or the recruitment of foreign doctors into Ethiopia. Instead, the country has invested in simple, bare-bones clinics that are run by minimally educated community health workers.

Foos Muhumed Gudaal is one of 35,000 rural health extension workers in Ethiopia. She practices at a post in the village of Walgo Yar in the eastern part of the country. The clinic is a simple, cement building with only two rooms: one for Gudaal to live in and one that serves as a consultation room. There is no electricity. There are no lights.

Gudaal's role at the post is a bit like the old image of a small-town pediatrician. But she isn't even a nurse. Instead, Gudaal, along with all of the other health extension workers, has gone through a special, one-year training program.

Her salary isn't anywhere near that of a pediatrician, either. She earns roughly $35 each month.

But Gudaal can still treat the diseases that often cut a child's life short in Ethiopia. And she can make sure kids in the village are up to date on their vaccines.

One of the main conditions Gudaal deals with is malaria. The parasite kills about 600,000 people worldwide each year, and the vast majority of those deaths occur in children younger than 5. Gudaal can diagnose and treat most malaria cases at her health post.

She can also easily treat diarrhea and respiratory infections, two other major killers of children in the developing world.

Because there is no electricity at the clinic, Gudaal has to rely on a kerosene-fired refrigerator to keep her vaccines cold. The aging fridge sits in a small shed next to the consultation room.

Gudaal lifts several vaccine vials out of the fridge. She not only administers immunizations but also keeps records for who in the village needs shots and boosters.

Since being launched a decade ago, this health extension program in Ethiopia has had a huge effect in the country, Salama says.

Quite simply, it has saved lives. "Children are now treated right across the country on a scale that was previously unheard of around the world," he says.

"Take acute severe malnutrition, for which Ethiopia was famous in the '70s and '80s," Salama says. "Today, successfully, these same lady health workers treat 300,000 children [each year] for severe malnutrition." Previously, these children would have most invariably died, he says.

Despite these improvements, Ethiopia still has a long way to go when it comes to children's health. Malnutrition is still the leading cause of death for children younger than 5 in the country. Nearly 20 percent of Ethiopian babies are born underweight, weighing less than 5 1/2 pounds. And about 40 percent of kids don't reach a normal height because of malnutrition.

But, Salama says, the beauty of Ethiopia's health extension program is that it's sustainable. It's run by the government, not a foreign foundation or agency. So as long as there's the political will, it's able to reach kids across the country.

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Transcript

AUDIE CORNISH, HOST:

Save a child in Africa has almost become a cliche in certain charities' advertising campaigns. In the 1970s and '80s, images of starving Ethiopian kids stared down from billboards and out of news photos. Ethiopia, however, is no longer the land of dying children. NPR's Jason Beaubien reports on one program that helped change things.

JASON BEAUBIEN, BYLINE: This is the Walgo Yar health post in eastern Somali region of Ethiopia. It's a simple cement brick building with just enough room for the health worker to live in one room, have a consultation room in the next. There's no electricity. There's no lights. Despite its simplicity, it's health posts like this one which have allowed Ethiopia to dramatically cut its child mortality rate over the last two decades.

FOOS MUHUMED GUDAAL: (Foreign language spoken)

BEAUBIEN: Foos Muhumed Gudaal is one of 35,000 rural health extension workers in Ethiopia. She's part of an army recruited, trained and deployed by the government to provide barebones health care across the country.

GUDAAL: (Foreign language spoken)

BEAUBIEN: One of the main conditions she deals with is malaria. She describes how she can treat most malaria cases right here in her small clinic. She also sees a lot of kids with diarrhea and respiratory infections. These are conditions that continue to be major killers in many parts of the developing world, and 20 years ago, claimed tens of thousands of lives each here. But they're relatively easy to treat.

UNIDENTIFIED MAN: (Foreign language spoken)

BEAUBIEN: Because there is no electricity at the clinic, Gudaal has to rely on a kerosene-fired refrigerator to keep her vaccines cold. The aging fridge sits in a small shed next to the consultation room.

GUDAAL: (Foreign language spoken)

BEAUBIEN: Gudaal lifts several vaccine vials out of the fridge. She not only administers the immunizations, it's also her job to make sure kids in her village get vaccinated. She keeps records and reminders of who needs what boosters and when. Gudaal's role is a bit like the old image of a small-town pediatrician, but she isn't even a nurse. Instead, Gudaal, along with all the other health extension workers, has gone through a special one-year training program. Her salary also isn't anywhere near that of a pediatrician's. She earns roughly $35 a month.

Since being launched a decade ago, Ethiopia's health extension worker program has had a huge impact in the country. Peter Salama, the head of UNICEF in Ethiopia, says quite simply, it's saved kids lives.

DR. PETER SALAMA: If you're a kid born in 1990, you had one in five chances of not surviving to your fifth birthday. One in five children did not survive to their fifth birthday. Today, they've dropped that mortality by around two-thirds. So a tremendous achievement in the space of two decades.

BEAUBIEN: Ethiopia used to have one of the highest rates of child mortality anywhere in the world.

SALAMA: And if you take something like severe acute malnutrition, what Ethiopia was famous, if you like, in the 1970s and '80s, today, successfully, these same lady health workers treat 300,000 children for severe acute malnutrition successfully who would otherwise almost invariably die.

BEAUBIEN: Every year, it's been...

SALAMA: Every year, 300,000. These children are now treated right across the country at a scale that was previously unheard of around the world.

BEAUBIEN: Salama says, part of the beauty of Ethiopia's health extension workers program is that it is not an international development project. It's run by the government. So as long as there's the political will, the program is sustainable and is able to reach kids across the entire country. Jason Beaubien, NPR News. Transcript provided by NPR, Copyright NPR.